Magnesium sulfate tocolysis and risk of neonatal death.
OBJECTIVE
Our purpose was to evaluate the association between in utero exposure to magnesium sulfate and neonatal death.


METHODS
Case-control comparison was performed of singleton infants who died at 0 to 28 days and control infants who survived to age 3 years and did not have disabling cerebral palsy. All subjects were born between 1983 and 1985 to mothers resident in one of four northern California counties.


RESULTS
Magnesium sulfate tocolysis was associated with a decreased risk of neonatal mortality (odds ratio 0.25, 95% confidence interval 0.6 to 1.1). Adjustment for birth weight and gestational age increased the inverse association (odds ratio 0.09, 95% confidence interval 0.01 to 0.93). The association between neonatal mortality and magnesium sulfate was not altered by maternal infection, gender, maternal race or ethnicity, maternal age, level of care, breech presentation, surgical delivery, corticosteroids, abruptio placentae, placenta previa, or bleeding on admission.


CONCLUSIONS
Magnesium sulfate tocolysis was not associated with increased neonatal mortality in premature infants. Thus any association of magnesium with reduced long-term neurologic morbidity is unlikely to be the result of selective mortality of vulnerable infants.
Grether
J K
JK
California Birth Defects Monitoring Program, California Department of Health Services, Emeryville, CA 94608-1811, USA.
Hoogstrate
J
J
Selvin
S
S
Nelson
K B
KB
D001724:Birth Weight / Q000502:physiology; D002140:California / Q000453:epidemiology; D016022:Case-Control Studies; D002547:Cerebral Palsy / Q000453:epidemiology; D005260:Female; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007226:Infant Mortality; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology; D019102:Infant, Very Low Birth Weight / Q000502:physiology; D008278:Magnesium Sulfate / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D007752:Obstetric Labor, Premature / Q000517:prevention & control; D010922:Placenta Diseases / Q000453:epidemiology; D011225:Pre-Eclampsia / Q000453:epidemiology; D011247:Pregnancy; D012307:Risk Factors; D015145:Tocolysis / Q000009:adverse effects* / Q000379:methods; D015149:Tocolytic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D014552:Urinary Tract Infections / Q000453:epidemiology
D015149:Tocolytic Agents; D008278:Magnesium Sulfate